Impact of Dasatinib on Female Reproductive Health in Philadelphia-Positive Leukemia Patients.

Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of chronic myeloid leukemia (CML), with patients now achieving life expectancy comparable to the general population. Despite the contraindication of TKIs during the first trimester of pregnancy, their effects on female reproductive health remain underexplored. This pilot case-control study evaluated the impact of Dasatinib on the female reproductive system in 25 women with CML or Philadelphia-positive acute lymphoblastic leukemia (Ph + ALL), compared to 25 age-matched controls. Clinical histories, gynecological examinations, transvaginal ultrasonography, and serum Anti-Müllerian hormone (AMH) assessments were performed. There was no significant differences in menstrual cycle characteristics between patients and controls, although 12% of patients experienced shorter cycles and 8% reported heavier menstrual flow after initiating Dasatinib. Notably, patients on Dasatinib had significantly lower serum AMH levels (p < 0.005) and a higher incidence of low antral follicle count (AFC < 5 mm). Abnormal cervical cytology was observed in one patient, and two tested positive for HPV DNA. Dasatinib may subtly but significantly affect ovarian reserve and cervical health. Larger studies are needed to clarify these reproductive effects and inform clinical management in women receiving Dasatinib therapy.